AARP: Health care reform will ultimately be good

TROY -- The new health care reform bill will ultimately be a good thing for those over 55, according to the AARP,

The nonprofit organization supported the bill, which is expected to extend affordable health insurance to some 32 million currently uninsured Americans starting in 2014.

"We applaud the House for passing this critical legislation to make our health care system work for more Americans," said AARP CEO A. Barry Rand in a statement.

Many of AARP's constituents have been particularly concerned on how the bill will affect their Medicare benefits, but the organization says the legislation contains a number of provisions that will ultimately benefit seniors and their families. In an effort to combat what they say are scare tactics and misinformation perpetuated by opponents of the bill, AARP is striving to make sure seniors properly understand what the bill means.

Advertisement

"It's a lot easier to scare someone than it is to education them," said national spokesman Jim Dau.

AARP officials said Thursday that the legislation will guarantee basic Medicare benefits and gradually close the so-called "doughnut hole" in drug coverage, which refers to the difference of the initial coverage limit and the catastrophic coverage threshold as described in the federal Medicare Part D prescription drug program. After a Medicare beneficiary surpasses the prescription drug coverage limit for the year, they're financially responsible for the entire cost of prescription drugs until the expense reaches what's determined to be the catastrophic coverage threshold. At that threshold, which is around $6,000, Medicare Part D kicks back in and covers 95 percent of drug costs.

The average out-of-pocket costs for those in the gap are around $3,600 a year, according to AARP.

In New York, 2.9 million people receive Medicare benefits, which are available to those over 65 and younger people with certain disabilities.

Medicare beneficiaries will be eligible this year for a $250 rebate for those in the "doughnut hole," and there will be a 50 percent discount for brand-name drugs for those people in 2011. The organization predicts that eventually that gap will be fully closed for its members.

An estimated 949,000 people in New York hit the "doughnut hole" in 2009, more than half of the number of residents receiving Medicare benefits, according to Bill Ferris, legislative representative for AARP New York. That number could swell to almost half of the number of New Yorkers receiving Medicare benefits by year's end.

The new legislation will also help ensure that seniors can get the health care services they need to be able to continue living in their own homes, rather than having to move into nursing homes or other residential facilities, according to Lisa Davis, AARP's vice president of public education. That includes giving states new financial incentives to provide home and community-based care to keep Medicare recipients living in their homes.

That move will be mutually beneficial for the states and for beneficiaries, who usually would prefer to stay in their homes. In New York, over 75 percent of the care in nursing homes and other residential facilities is paid for by Medicaid, said Ferris. Not only will putting a renewed emphasis on home-based care help Medicare beneficiaries, but it will also save taxpayers' money.

Another major change provided in the legislation is that many preventative services, including cancer screenings, will now be free for Medicare beneficiaries, and they won't have to shell out co-pays for those services. It's also aimed at reducing the rate of re-admissions and repeat hospitalizations, and hospitals will no longer be rewarded for what are determined to preventable readmissions. If a patient is readmitted to the hospital within 30 days for the same reason as the original visit, the hospital will not be paid for the second hospitalization, according to AARP.

The Medicare savings achieved through the legislation will actually extend the solvency of the program by nearly a decade, according to AARP's Nora Super.

"No one pretends that health care costs won't continue to rise, but those skyrocketing increases will be restrained," said Super, director of federal government relations.

Additionally, the bill will help seniors concerned about their children, by allowing them to keep their kids on their health insurance policy until they reach the age of 27. The welfare of their families is a big issue for AARP members, the organization says, and that aspect of the bill will reduce some worry.

The bill will also prevent exorbitant premiums based on age, as well as caps on coverage for ongoing health problems, said Davis. It will also help secure retiree health benefits.

The organization said it won't stop working to improve health care for seniors despite the bill's passage.

They say they will continue to work to lower the cost of prescription drugs, and would like to make sure that the secretary of health and human services has the ability the negotiate drug prices with pharmaceutical companies. They'll also continue working to help the federal government set up new temporary insurance high-risk pools to help those having difficulty finding health insurance coverage now.